The United States and Canada recognizes the rights of people with disabilities to access quality healthcare. The two countries have established strong legislative frameworks ensuring disabled persons have access to universal healthcare. In 2018, Centers for Disease Control and Prevention (CDC) revealed that, over 48 million people in America are living with different types of disabilities ( Kuper & Hanefeld, 2018) . In that sense, the government has come up with various programs to accommodate individuals with disabilities. According to 2017 statistics by the Canadian Survey on Disability (CSD), an estimated 6.2 million Canadians live with disability ( Kuper & Hanefeld, 2018) . The Canadian government has strived to understand the difficulties facing persons with disabilities, in a bid to come up with appropriate government policies. However, the frameworks created by the two countries are faced with challenges that include stigma, discrimination, racism, and superstition among others. In fact, a keen look at people living with disabilities in the United States and Canada reveals sharp contrasts and similarities ranging from healthcare services, social, cultural, political, and economic factors in accessing healthcare services.
Healthcare Systems
Notably, the healthcare system in the United States serves as a boost to the life of people with disabilities. It ensures the disabled access specialist services, rehabilitation and general healthcare services to help them cope with various impairments ( Thompson, 2015) . At the same time, the healthcare system is designed with the disabled in mind, as it ensures they can access the services they need at a reasonable cost. The United States government has designed the system specifically to ensure that, people with disabilities have equal access compared to their non-disabled counterparts ( Brown, 2016) .
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At the same time, the Canadian government ensures all persons have access to quality healthcare. To ensure the system supports the disabled, the government is keen on providing tax support on healthcare costs, disabled dependents and their caregivers ( Brown, 2016) . However, individuals with disabilities experience numerous challenges while accessing medical care, compared to non-disabled persons. In terms of healthcare accessibility, doctors are reluctant to meet people with disabilities because they consume a lot of their time.
Social Factors
Notably, community members’ personal characteristics namely race and sexual orientation determine the manner in which disabled people receive optimum healthcare. Disabled LGBT are subjected to a pathway of discrimination and stigma that excludes access to healthcare services ( Thompson, 2015) . In the United States, people with disabilities find it difficult to access healthcare services due to discrimination, and prejudice. Statistics indicate that the prevalence of disability is 20.5% for African Americans, 13.1% for Latinos/Hispanics, and Asian Americans assume 12.4% ( Nakkeeran & Nakkeeran, 2018) . A report by the Institute of Medicine report admits existence of ‘clear racial differences’ in utilization of medical services for people with disabilities owing to discrimination, class or culture ( Nakkeeran & Nakkeeran, 2018) . Inadequate equipment in most outpatient facilities lead to delayed care, missed diagnoses, and fewer preventive tests. The most affected by such problems are the minorities since they occupy highest percentage of Americans with disabilities. People of color find it difficult to access healthcare because of stereotypes, physical inaccessibility, and coverage limitations among others.
In Canada, the situation is not any different. People of color living with disabilities need greater healthcare needs, which pose a huge problem. They face discrimination, and existence of barriers in access to healthcare services ( Brown, 2016) . Racism and language barrier prevent disabled people to gain access to quality healthcare services. For instance, Tamil refugees and immigrants with physical disabilities suffer from lack of services due to language barriers. In addition, disabled persons from the Arab community living in Canada face major concerns in accessing healthcare for lack of interpreters.
Cultural Factors
In the United States, cultural factors affect the disabled communities. They are denied respect, social integration, and their pursuit for happiness is faced with many challenges. According to UNICEF, individuals with disability are neglected, subjected to superstition, and isolated from the society ( Krahn, Walker & Correa-De-Araujo, 2015) . Classified as a social issue, disability hinders people from participating in society on equal basis.
In comparison, the current Canadian healthcare system does not guarantee equitable access to individuals of all cultural groupings ( Thompson, 2015) . People with disabilities seeking culturally sensitive services do not get full benefits. Health Canada has reported that, the type of healthcare services are determined based on dominant cultural values.
Political Factors
The political system in the United States affects the access to services among people with disabilities. For instance, since the Republican affiliated president was elected, proposals within the Congress were aimed at repealing the Affordable Care Act ( Kuper & Hanefeld, 2018) . Meaningfully, the repeal would mean cutting Medicaid, which is the major health insurer for children and adults with disabilities. The Medicaid insurance covers services that other insurers ignore among them lifts and personal care agents, which allow the disabled to live in their communities and homes.
In Canada, politics determine policies that affect access to services for the disabled people. In 2019, the Liberals gave royal assent to the Accessible Canada Act. The policy touches on affordable housing, health, and infrastructure. During campaigns, the Liberals promised to double the child benefits for disabled children, put up annual $40 million national fund to help Canadians with disability to find employment, and simplify the procedure of accessing benefits for the disabled veterans. However, during the 2019 campaigns People’s Party of Canada observed it lacked any policy for the PWD ( Kuper & Hanefeld, 2018) .
Economic Factors
In United States, the Federal Government has established two programs to assist individuals with disabilities. Disabled people have access to an insurance program called Social Security Disability Insurance (SSDI). People with low income without work history are entitled to the Supplemental Security Income (SSI) ( Kuper & Hanefeld, 2018) . They also have automatic access to Medicaid. Although they have access to such benefits, people with disabilities in US are mostly jobless and live in poverty. Research on healthcare and disability indicate that people with disability face challenges of accessing healthcare due to concerns such as insurance, problems of transportation and communication ( Krahn, Walker & Correa-De-Araujo, 2015) .
In Canada, most disabled people of color, experience low socio-economic status, making it difficult to access good health, and education among other services. However, the government came up with disability benefits for the working-age population, health insurance, and survivor benefits, which continues to offer provisions for PWD. The Canadian Disability Policy Alliance revealed that, the major problem facing the disabled is the transportation cost to appointments ( Kuper & Hanefeld, 2018) . Most individuals with disabilities do not have independent transportation means.
Conclusion
Undoubtedly, the United States and Canada have sections of their population living with disabilities. Evidently, when it comes to access of various government services such as healthcare and education, people with disabilities are disadvantaged, while compared with their nondisabled counterparts. Although the healthcare systems in the two nations are committed to help improve their lives, the disabled encounter challenges from lack of insurance and transportation to get doctor’s appointment. Evidently, social, cultural, political, and economic factors determine the manner in which people living with disabilities interact and access government services.
References
Kuper, H., Hanefeld, J. (2018). Debate: can we achieve universal health coverage without a focus on disability? BMC Health Serv Res 18, 738. https://doi.org/10.1186/s12913-018- 3547-2
Brown, E. (2016). Disability awareness: The fight for accessibility. Nature 532, 137–139. https://doi.org/10.1038/nj7597-137a
Krahn, G. L., Walker, D. K., & Correa-De-Araujo, R. (2015). Persons with disabilities as an unrecognized health disparity population. American journal of public health, 105 Suppl 2(Suppl 2), S198–S206. https://doi.org/10.2105/AJPH.2014.302182
Nakkeeran, N. & Nakkeeran, B. (2018). Disability, mental health, sexual orientation and gender identity: understanding health inequity through experience and difference. Health Res Policy Sys 16, 97. https://doi.org/10.1186/s12961-018-0366-1
Thompson, A. E. (2015). The Americans with Disabilities Act. JAMA. 313(22):2296. doi:10.1001/jama.2015.6296
